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Hypopnea Clusters
#1
Question 
I have been on APAP now for 90 days with good results for OA and CA but I am still being plagued by Hypopnea. Last night for example 23 H events were recorded in 6:38, not a bad result you might say but the events are clustered, 3 events within 19 minutes again not too bad, then 8 events in 14 minutes, again 8 events in 28 minutes and a couple of isolated events to make up the total. Not only are these clustered but they are surprisingly regular with major clusters regularly betwen 1:30-2:00 AND 3:30-4:00.
Current settings are pressure min 6 max 17, EPR 3, Humidity and Line Temp on Auto.
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#2
It could be just a matter of raising your minimum starting pressure a little. Mabye to 6.5 or 7 and watch for awhile.
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#3
(09-21-2015, 05:18 PM)robanco Wrote: Current settings are pressure min 6 max 17, EPR 3, Humidity and Line Temp on Auto.
What is the median, 95th percentile, and maximum pressure and leak?
I prefer to set my minimum pressure close to the 95th percentile so pressure doesn't have to climb a great deal to deal with any events and not a lot of variation in pressure during the night ... YMMV

I'm not fan of EPR and don't think necessary if on variable pressure, I would turn it off
Some people might disagree, that is normal, everyone is different

As for humidity, I set the control on manual ... tube temp 23C - humidity 3, no rainout
On auto, the air feel too warm for me, unlike later models, tube temp is not adjustable on my machine ...
What is good from someone, not necessarily good for someone else
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#4
All good advice above... In my own words:

Use the software and see where the pressure is for the clusters of hypos. I'd wager it's when the autoset has retreated on pressure.
If so, then raising the min pressure would likely reduce clustering.

Also, look at your high sample rate flow data to see if it's reduced in amplitude during the time frame of the clusters -- another indication partial airway restriction.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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